Abstract
BackgroundMost smokers have their first experience of cigarette use when they are teenagers (i.e. at schools). Aiming tobacco control initiatives at secondary school students offers preventive measures to eliminate or reduce tobacco use initiation by students. This study assessed smoking-related attitudes, motives and behavior as well as other factors associated with smoking among male secondary school students in an urban setting in China.MethodsA cross-sectional survey was conducted in urban areas of Chongqing using a structured questionnaire administered to 1297 male secondary school students. Logistic regression analysis was employed to investigate the factors that affect smoking.ResultsOf the participants (n = 1297), 27.7% were secondary and 72.3% were middle school students. Overall, 30.5% of the participants were smokers. The majority of the students procured their first cigarette from friends. The motivations of middle school students to smoke their first cigarette were curiosity (70.5%) and imitation (13.1%). The motivations of high school students for smoking their first cigarette were to satisfy their curiosity (51.8%), relief of stress and social pressures (17.1%), and imitation of smoker friends (15.9%). Respondents from poor family financial conditions were more likely to smoke than those from rich family financial conditions [odds ratio (OR) 1.59, 95% confidence intervals (CI) 1.00, 2.52]. Respondents whose fathers were smokers were more likely to smoke than those whose fathers were non-smokers (OR 1.65, 95% CI 1.25, 2.17). Respondents who had one or two smoker friends (OR 2.98, 95% CI 1.93, 4.60) and three or more smoker friends (OR 5.92, 95% CI 4.35, 8.05) were more likely to smoke than those who did not have any. Respondents who were neutral (OR 0.43, 95% CI 0.20, 0.91) and disagreed about the item “friends smoking” (OR 0.18, 95% CI 0.08, 0.39) were less likely to smoke than those who agreed with the item.ConclusionsThis study indicates that male students who have negative attitudes toward smoking, who do not have a father or friends who smoke, and are from affluent backgrounds exhibit low tendency to start smoking at a young age. This study provides some implications for tobacco control policies among male secondary school students in urban settings.
Highlights
Most smokers have their first experience of cigarette use when they are teenagers
The study was conducted in accordance with the Declaration of Helsinki, and the protocol was approved by the Ethics Committee of Chongqing Medical University
KAP model is based on the principle that increasing knowledge will result in changed attitudes and practices to minimize the burden of diseases (Mascie-Taylor et al 2003)
Summary
Most smokers have their first experience of cigarette use when they are teenagers (i.e. at schools). This study assessed smoking-related attitudes, motives and behavior as well as other factors associated with smoking among male secondary school students in an urban setting in China. 90% of adult smokers began smoking before reaching 18 years old in the US (U.S Department of Health and Human Services 2012), and approximately 40% of adolescent smokers in China started smoking before reaching 10 years old (Hesketh et al 2001). Tobacco control among adolescents is necessary and important to prevent many long-term diseases associated with smoking (U.S Department of Health and Human Services 1994, 2012). Based on the 2014 China Youth Tobacco Survey Report, overall 6.9% of junior middle and high school students smoked; the prevalence in male students (11.2%) was higher than in female students (2.2%) (China Center for Disease Control and Prevention 2014). Teenagers are in the period of growth and development, when all physiological systems and organs are not yet fully developed; their unique physiological characteristics make them more susceptible to tobacco (Centers for Disease Control and Prevention 1994)
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